Tuesday, September 26, 2017

Last year on December 19, the mayor of Washington, DC, Muriel Bowser, signed into law the "Death with Dignity Act," which permits people to request and receive a lethal dose of drugs to end their lives. Congress, however, has the authority to review and reverse decisions made by the DC Council, and the House has approved a measure with a provision that would terminate the assisted-suicide law. The House bill goes to the Senate now.

"Assisted suicide is sold to us as a lie," says Schadenberg. "They sell it as about choice and autonomy which, of course, is what everybody is in favor of. But what it's actually doing is giving a doctor the right to cause your death – and it's a very, very serious situation because it's dealing with people who are at the most vulnerable time of their life."

Schadenberg says bills to legalize assisted suicide were introduced in 26 states this year and all were defeated. As recently as last week, the New York State Court of Appeals ruled there is no constitutional right to assisted suicide.

"It's not a juggernaut," says Schadenberg, "and when people look at what it's actually about, they recognize how bad it is and they actually vote to defeat it. I'm hoping that the Senate has the strength to do the same."

In Canada, assisted suicide was imposed on citizens by a ruling from the Canadian Supreme Court.

Wednesday, September 20, 2017

The New Zealand Māori Party are urging people not to vote for the Labour Party because of their stance on euthanasia and assisted suicide. The Newshub in New Zealand reported:

In a statement released by the party, Tuilagi Saipele Esera, Māori Party Candidate for Manukau East, said Labour's intention to legalise euthanasia and assisted suicide was against Christian and Pacific cultural values.

"Euthanasia and assisted suicide is a rejection of the importance and value of human life. Do not vote Labour."

Labour Party leader Jacinda Ardern has previously expressed support for ACT leader David Seymour's End of Life Choice Bill, which would give "people with a terminal illness or a grievous and irremediable medical condition the option of requesting assisted dying".

Mr Esera urged Pacific leaders and communities to "not second guess" what Labour would do if elected.

The American College of Physicians (ACP) has published an updated position on assisted suicide and yet the updated position continues to clearly oppose physician-assisted suicide while urging excellent pain and symptom management. Link to the ACP position statement.

The Position of the ACP:

The ACP affirms a professional responsibility to improve the care of dying patients and their families.

The ACP does not support the legalization of physician-assisted suicide, the practice of which raises ethical, clinical, and other concerns. The ACP and its members, including those who might lawfully participate in the practice, should ensure that all patients can rely on high-quality care through to the end of life, with prevention or relief of suffering insofar as possible, a commitment to human dignity and management of pain and other symptoms, and support for families. Physicians and patients must continue to search together for answers to the challenges posed by living with serious illness before death

The ACP conclusion:

Society's goal should be to make dying less, not more, medical. Physician-assisted suicide is neither a therapy nor a solution to difficult questions raised at the end of life. On the basis of substantive ethics, clinical practice, policy, and other concerns, the ACP does not support legalization of physician-assisted suicide. This practice is problematic given the nature of the patient–physician relationship, affects trust in that relationship as well as in the profession, and fundamentally alters the medical profession's role in society. Furthermore, the principles at stake in this debate also underlie medicine's responsibilities on other issues and the physician's duty to provide care based on clinical judgment, evidence, and ethics. Control over the manner and timing of a person's death has not been and should not be a goal of medicine. However, through high-quality care, effective communication, compassionate support, and the right resources, physicians can help patients control many aspects of how they live out life's last chapter.

The position of the ACP recognizes the importance of the patient/physician relationship and the importance of caring for and not killing patients.

Tuesday, September 19, 2017

Many euthanasia and assisted suicide proponents frame their arguments around “facts” and declarations that there is a majority of citizens who support such legislation. Yet, when you take a closer look, their “strong” basis for support is based on misconceptions about such legislation – and misconstrued facts!

Myth 1: Public polls are reliable, and a decision about assisted suicide must accord with their results.

Reality: a poll about any matter is only useful to the extent that the question asked is realistic, and those polled have some knowledge about the matter…. Is it clinically realistic to ask a question like “Are you in favour of assisted suicide if someone has uncontrollable pain, and is terminally ill?”

A reading of the 1037 submissions to the Victorian parliamentary committee shows that such scenarios have occurred in the past (before palliative care was available) but should not be the case in 2017, now that modern palliative care is available – if people will use it. Good pain control measures are now possible if used properly.

Myth 2: Pain is the main issue.

Reality: Recent research with people in Canada who requested assisted suicide shows that pain is not the main issue. The main reason given was a desire for control of personal circumstances.

This means that the “uncontrollable pain” issue has been used somewhat as a selling point, and the assertion of ‘autonomy’ is the main underlying issue. However, an assisted suicide process is not really autonomy, since others would be involved, and to exercise such choice would require a major change to medical ethics.

Myth 3: Doctors can tell you how long you have to live.

Reality: Doctors can give five-year survival rates. No doctor can tell you how long a person has to live. Such comments are guesswork. A guideline for PAS involving a 12-month prognosis is an illusion.

Myth 4: Assisted suicide would affect that individual only.

Reality: A law change affects everyone in the community. Hence there is a need to evaluate the effect of PAS law on the common good and medical practice. The fact is that in The Netherlands, and Belgium, the criteria have slipped to include not just people who appear terminally ill, but those with psychiatric illness who are physically well, and those who state they suffer in some way (but who are not assessed for any possible treatment).

Myth 5: Families are always benign and caring.

Reality: Evidence is that elder abuse is most likely from those close to a person, especially family. It is also a reality that when a person is seriously ill, many family members find it very stressful, and have quite mixed feelings about the ill person: part of you wants them to go on; part of you wants the whole experience over asap. I have experienced this myself. It makes a seriously ill person vulnerable to coercion from family to go down the assisted suicide path.

Myth 6: Likely guidelines are adequate safeguards.

Reality: The guidelines set out by the Victorian Ministerial Advisory Panel do not provide for any medical assessment of palliation at all. They do not provide for a genuinely independent medical opinion and do not attempt to detect coercion of the person. The door to elder abuse is left wide open.

Myth 7: The standard of future healthcare will not be affected.

Reality: As has become apparent overseas, healthcare economists soon realize that it is likely cheaper for the bureaucracy to offer a ‘comfort medication’ (suicide pill) than to pay for palliative care or chemotherapy. It is therefore very likely that assisted suicide legislation will distort future health care delivery – and that conclusion is drawn without even considering the expense of future dementia care.

These myths and misconceptions can have (literally) deadly consequences. Before any decisions or even debate takes place, all citizens have the right to fully understand what effects potential euthanasia and assisted suicide legislation could have, AND what other options exist.

Prematurely killing people as a means to escape pain and fear is not the answer. Instead, we can focus on making care and life better for all citizens, at all ages and for any condition.

This excellent article is written by Kenny Fries, an author who recently published “In the Province of the Gods.” Fries is writing about his explanation to a young German neurologist of the truth about how the Nazi's T4 euthanasia program killed as many as 300,000 people with disabilities. The killing techniques were developed in the Psychiatric hospitals and then used in the Nazi death camps. Fries takes the killing of people with disabilities personally:

I have a personal stake in making sure this history is remembered. In 1960, I was born missing bones in both legs. At the time, some thought I should not be allowed to live. Thankfully, my parents were not among them.

I first discovered that people with disabilities were sterilized and killed by the Nazis when I was a teenager, watching the TV mini-series “Holocaust” in 1978. But it would be years before I understood the connections between the killing of the disabled and the killing of Jews and other “undesirables,” all of whom were, in one way or another, deemed “unfit.”

Nazi euthanasia victims

Many facts about the Nazi T4 euthanasia program are not well known. Fries explains:

While he does know that approximately 300,000 disabled people were killed in T4 and its aftermath, he doesn’t know about the direct connection between T4 and the Holocaust. He doesn’t know that it was at Brandenburg, the first T4 site, where methods of mass killing were tested, that the first victims of Nazi mass killings were the disabled, and that its personnel went on to establish and run the extermination camps at Treblinka, Belzec and Sobibor.

Three years earlier, when I first arrived in Germany, I was consistently confronted with the treatment of those with disabilities under the Third Reich. But I soon realized I had to go back even farther. In the 1920s, the disabled were mistreated, sterilized, experimented on and killed in some German psychiatric institutions. In 1920, the psychiatrist Alfred Hoche and the jurist Karl Binding published their treatise, “Permitting the Destruction of Unworthy Life,” which became the blueprint for the exterminations of the disabled carried out by the Third Reich.

I am also Jewish. At the Karl Bonhoeffer psychiatric hospital in the Berlin suburb of Wittenau, where the exhibition “A Double Stigma: The Fate of Jewish Psychiatric Patients” was held, I learned about, as the exhibition title suggests, how Jewish patients were doubly stigmatized by being separated from other patients, denied pastoral care, and were cared for not at the expense of the Reich but by Jewish organizations. Jewish patients were singled out for early extermination; by December 1942, the destruction of the Jewish patient population at Wittenau was complete.

Nazi euthanasia victims

Fries explains why the history of the Nazi T4 euthanasia program important to us today:

Why is it important to know this history? We often say what happened in Nazi Germany couldn’t happen here. But some of it, like the mistreatment and sterilization of the disabled, did happen here.

A reading of Hoche and Binding’s “Permitting the Destruction of Unworthy Life” shows the similarity between what they said and what exponents of practical ethics, such as Peter Singer, say about the disabled today. As recently as 2015, Singer, talking with the radio host Aaron Klein on his show, said, “I don’t want my health insurance premiums to be higher so that infants who can experience zero quality of life can have expensive treatments.”

These philosophers talk about the drain on “resources” caused by lives lived with a disability, which eerily echoes what Hoche and Binding wrote about the “financial and moral burden” on “a person’s family, hospital, and state” caused by what they deem lives “unworthy of living.”

Many people think that these attitudes towards people with disabilities are in the past. Fries asks the question:

What kind of society do we want to be? Those of us who live with disabilities are at the forefront of the larger discussion of what constitutes a valued life. What is a life worth living? Too often, the lives of those of us who live with disabilities are not valued, and feared. At the root of this fear is misunderstanding, misrepresentation, and a lack of knowledge of disability history and, thus, disabled lives.

Friday, September 15, 2017

A case in Canada demonstrates that people who are seriously ill or disabled need to be accommodated, and doing that does not include a lethal injection.

Candice Lewis

Candice Lewis, who was born with multiple disabilities, lives in a small Newfoundland community. When she was hospitalized last year, two doctors pressured her to agree to be euthanized and strongly suggested it to her mother.

"It was obvious she was going through conditions, ..., which may have been very, very great," explains Alex Schadenberg of the Euthanasia Prevention Coalition (EPC). "But the fact is that there was no request for euthanasia, and as you know, in Canada euthanasia is legal now. There was no request, there was no desire for this, but there was pressure from the doctors."

Lewis was ultimately transferred to another hospital where doctors found the problem was simply a need to adjust her medication. She is now doing better than ever and recently participated in her sister's wedding.

As for euthanasia, Schadenberg says proponents claim it is all about personal choice, but that is a big lie.

"That's one of the big cultural lies that they sell us because, in fact, what it is is that it gives the doctor the right in law to cause your death. And once the doctor has that power, you have to understand that goes along with their own attitudes, their own levels of discrimination, their own feelings," the EPC executive points out. "Obviously the doctors were saying, 'I wouldn't want to live like you, Candice.'"

Thursday, September 14, 2017

Join us for the 2017 National Euthanasia Symposium. It is an opportunity for us to learn from each other and network with like-minded people. It is happening this year on Saturday, October 28 from 9 am - 5 pm at the Best Western Premier Toronto Airport Carlingview Hotel.

New this year, we are live streaming of the Symposium to enable anyone to watch the Symposium live, anywhere in the world. We will send you the link and code to log in for only $30.

We have arranged for many amazing speakers:

Dr. Mark Komrad is an American professor and psychiatrist who will speak about opposing euthanasia for psychiatric reasons. He has written a book on how to convince troubled family members, loved ones and friends to get psychiatric evaluation and treatment. Mark specialized in medical ethics in mental health care.

Jen Romnes

Jen Romnes is an artist, author and advocate who will speak about her personal experience opposing euthanasia. Jen has recently released her second book entitled Entangled 2: Betrayed From Within which continues the story of how she fought to protect her Mom from abuse. Her advocacy focuses on protecting people who become vulnerable due to diseases like Alzheimer’s.

Kevin Dunn is a movie producer who co-produced The Euthanasia Deception and many other documentaries for social change. Kevin is currently working on two new films for EPC and will speak on the topic of using media to drive social and cultural change.

Taylor Hyatt

Amy Hasbrouck, President of EPC and Taylor Hyatt, Policy Analyst and Outreach Coodinator for Toujours Vivant-Not Dead Yet will speak about the federal debate on expanding the euthanasia law in Canada from the perspective of people with disabilities.

Dr. Ramona Coelho

Dr. Ramona Coelho, a Medical Doctor in London, Ontario, will be speaking on physicians' conscience rights. Charles Lewis, a former columnist with the National Post and a member of the EPC Board, will be speaking about the need to care for and protect people from euthanasia.

Amy Hasbrouck
EPC President.

When booking your room at the Best Western, be sure to mention you are attending the Symposium to get the special conference rate of $109 (includes breakfast). Visit their website at www.bwptorontoairporthotel.com or call: 1-800-780-7234.Please share this information with any family members and friends who may be interested in learning more about how they can better resist the practice of euthanasia and assisted suicide in their community. We need you to become more involved in our work to create positive change.For more information call: 1-877-439-3348 or email: info@epcc.ca

Wednesday, September 13, 2017

September 10th, was World Suicide Prevention Day. The decision to end one’s own life should always be met with sorrow and grief; every effort should be made to prevent human beings from reaching that level of despair. However, our society seems to make an exception for old, ill and disabled people.

Disabled people encounter a variety of obstacles to living secure, fulfilling and independent lives compared to the general population. There is a shortage of affordable and accessible housing, as well as home-based assistance services. Many people end up being forced into institutions as a result. These environments severely restrict residents’ personal freedoms, while unsanitary conditions and unhealthy practices may rise to the level of inhumane treatment. People with disabilities are also more likely to be unemployed or live in poverty. Income supports often do not cover basic living expenses. Moreover, correcting any of these problems is commonly thought to be a burden. It’s no wonder that some wrongly believe it is better to die than be disabled.

When suicidal tendencies become obvious, self-destruction is assumed to be a reasonable choice because a disability is present. Should the person seek help, medical professionals overlook typical sources of stress. Instead of investigating the underlying problems – strained relationships or social isolation – the person’s behaviour is assumed to be motivated by the disability, and therefore rational. For people with mental health issues, the wish to die may even be a symptom of their condition. In fact, the Canadian Mental Health Association (CMHA) released a position paper this week stating that assisted suicide solely for psychiatric disabilities “should remain illegal” for this reason. People with all kinds of disabilities are therefore at greater risk of suicide. This situation cannot be overlooked.

To make matters worse, the Canadian government legalized “medical aid in dying” or “assisted death” last year. The procedure should be called by its true name: assisted suicide and euthanasia. A false distinction between two “types” of suicide has been created. Current suicide prevention efforts disregard the legally-sanctioned form in an effort to avoid limiting personal choice. This approach makes no sense. Whether or not you are disabled, and whether or not you engage medical professionals to participate in your death, suicide is suicide.

Suicide prevention should apply equally to everyone – including and especially people with disabilities. Until that happens, we will be denied our rights to self-determination and full participation in society.www.tvndy.ca / info@tv-ndy.ca / 450-921-3057

Goldberg and Cowan write about the issue based on several topic areas. They start their article by referring to the quick expansion of euthanasia "MAiD" in Canada.

In Canada, “natural death” must be “reasonably foreseeable” before a doctor may euthanize a patient. In spite of such statutory language, in A.B. v. Canada, a case decided this June, the Court judged that the anticipated natural death need not be “imminent”; it need not even be “connected to a particular terminal disease or condition.” Rather, Justice Paul Perell concluded, “what is a ‘reasonably foreseeable death’ is a person’s specific medical question to be made without necessarily making, but not precluding, a prognosis of the remaining lifespan.” Physician-assisted suicide may go forward as long as a medical professional considers “all of a particular person’s medical circumstances.” One wonders in what sort of case death would not be reasonably foreseeable, under this loose standard.

The foundation for this decision was an earlier Canadian Supreme Court case, Carter v. Canada. It overturned the law that criminalized both the assisting of another’s suicide and the consenting to one’s own death, on the grounds that the law “unjustifiably infringed” upon the rights and freedoms of “competent adult persons.”

Goldberg and Cowan then write about the Contagion of euthanasia:

One vector for the contagion of euthanasia is the vagueness of the terms in which the conditions for termination of life are expressed. Alex Schadenberg, International Chair of the Euthanasia Prevention Coalition, provides a couple examples. A.B. v. Canada, the case cited above, arose because the petitioner’s doctor was unwilling to execute a woman with excruciating osteoarthritis, fearing that if he did so, he might be charged with murder. If the requirement that death be “reasonably foreseeable” is supposed to rule anything out, it probably should rule out killing someone with painful, non-terminal arthritis—yet the court found some way to justify the killing. Schadenberg also points to a case of a young man in a Vancouver nursing home who was diagnosed with a neurological disease and struggled to “find a cure with massive doses of vitamins.” Nowhere near dying, this man was nevertheless killed by a Vancouver physician.

The spread of the contagion is facilitated by financial motives also. Insurance companies, trying to save money, often seek to replace sanctity of life with so-called quality of life. Dr. Brian Callister, an associate professor at the University of Nevada School of Medicine and former head of the State’s Medical Association, attempted to transfer two patients to hospitals in other states, so they could receive potentially life-saving treatments unavailable in Nevada. His patients were denied insurance for their transfer and treatment. The insurers asked: “Have you considered suicide?” Speaking from personal experience, Dr. Callister says, “Assisted suicide changes the way we care for patients. It creates a dangerous segue to perverse incentives for insurance companies and there’s no going back from that.”

But Dr. Callister’s experience is not isolated. Stephanie Packer, a vibrant mother of four from California, suffers with scholoderma, a terminal condition. She was advised by her insurance company to seek a prescription from her doctor for a lethal medicine that would only cost her a $1.20 co-pay, instead of granting her the financial assistance she sought for life-affirming treatments at UCLA.

Goldberg and Cowan then examine the question of the Psychological Contagion of Suicide:

On his Fox News show, Tucker Carlson highlighted the negative effect of 13 Reasons Why, a Netflix show, on two teenage girls in California. According to their parents, the girls committed suicides after “bringing” on episodes of the show. They blamed their children’s deaths on the show’s glamorization of suicide, its presentation of suicide as a response to the stresses of teenage life.

It is perhaps no accident that Oregon, the first state to legalize assisted suicide, has a general suicide rate some 40 percent higher than the American national average. Whether legal “assisted suicide” fueled the State’s culture of suicide, or was fueled by an otherwise existing culture of suicide, the Oregon experience at least suggests that suicide as a culturally accepted “value” and legislation permitting “assisted suicide” go together.

The authors then examine the issue of conscience rights. They wrote:

Permitting euthanasia does not just harm those who are killed. It also harms those who are forced to kill, or else suffer legal consequences or be forced from a profession. Legislation implemented in Ontario—and similar legislation proposed in Victoria, Australia—forces physicians who oppose personal involvement in euthanasia or “assisted suicide” to “effectively refer” their patients to another physician who will kill. “Effective referral” is defined as a referral to carry out the purposes of the Act. That means a specific referral either “to someone who will do it or someone who will arrange it. Either way,” EPC Chair Alex Schadenberg explains, “it’s a referral for the purpose of death.” It thus denies conscience rights to medical professionals who do not understand killing their patients to be part of their craft.

In the view of Larry Worthen, executive director of the Christian Medical and Dental Association of Canada, when doctors are told they must send their patient to an executioner, “we are being forced to violate our deeply held religious beliefs. Effective referral and participating in assisted death are morally and ethically the same thing. This forces people of conscience and faith to act against their moral convictions and threatens the very core of why they became physicians, which is to help to heal people.”

Dr. Mark D’Souza, a palliative care physician and board director of Concerned Ontario Doctors, indicates that as a “conscientious objector,” he objects to killing a patient. As a result, he and several other doctors he knows will no longer accept patients needing palliative care. The palliative care system in the community in which he practices (Scarborough) is grossly under serviced. The effect of these retirements is to worsen available care for patients in severe pain. In addition to contradicting the very concept of palliative care, the availability of euthanasia also tends to undermine its practice; where euthanasia is available, funding for palliative care falls correspondingly.

The authors then examine the question of compassion:

Euthanasia therefore abandons people at their most vulnerable. Rather than providing compassion and support for people in their suffering, euthanasia presents a callous and insensitive “alternative.” As Viktor Frankl points out, the essential human dimension is neither body nor mind, but rather a soul or conscience with both mind and body as its vehicles and challenges. The task of soul or conscience is to respond purposefully and ethically to the predicaments of mind and body.

We can see a shining example of true compassion in the case of an Oregon resident, Jeanette Hall. After receiving a terminal diagnosis of cancer, she requested lethal drugs, thinking it appropriate to “do what our law allowed”—a law for which she voted. Her doctor, however, encouraged her not to give up, even though medical diagnosis gave her six months to live. A decade later she is still surviving.

The authors finally deal with the the inalienable rights and obligations we have towards persons. They conclude their article by stating:

In a previous Public Discourse essay, we spoke about the conditions required to achieve restoration of the political-moral center. One essential ingredient is to overcome a culture of sanctioned killing, to re-anchor our contemporary culture towards the protection of life, rather than its disposal. To do this we must crystallize into our collective consciousness the principles of the Noahide Code, the moral root of our great religious traditions and our civilization.

Thank you Arthur Goldberg and Shimon Cowen for researching issues related to euthanasia and assisted suicide from a Jewish point of view.

2. Continue to invest in community mental health and addiction services and supports,

3. Develop a national suicide prevention strategy,

4. Invest in research to accurately predict and understand the course of illness in mental health and substance abuse.

In December 2016 the American Psychiatric Association (APA) decided that in concert with the American Medical Association’s position on medical euthanasia, that a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.